Muscle Sympathetic Nerve Activity Burst Incidence Research Articles

Sympathetic Baroreflex Sensitivity is Enhanced in Postmenopausal Women.

The sympathetic nervous system is critical for regulating blood pressure (BP) via the arterial baroreflex as well as sympathetic transduction in the peripheral vasculature. These mechanisms interact and both may be altered with aging and impacted by menopause. Although age-related decreases in sympathetic transduction have been demonstrated in women, it remains unclear whether sympathetic baroreflex sensitivity (BRS) is impaired in postmenopausal women (POST). We tested the hypothesis that sympathetic BRS would be enhanced in POST compared to premenopausal women (PRE). We examined beat-by-beat BP and muscle sympathetic nerve activity (MSNA) in 19 PRE (22±2 yr, 22±3 kg/m2) and 12 POST (57±5 yr, 24±2 kg/m2) during 10 minutes of rest. Spontaneous sympathetic BRS was quantified as the slope of a linear regression between MSNA burst incidence and diastolic BP. Sympathetic transduction to mean arterial pressure (MAP) for the 10-cardiac cycles following spontaneous MSNA bursts was assessed via signal averaging method. Resting MAP was similar (PRE: 82±8 vs. POST: 85±8 mm Hg, P=0.43), whereas resting MSNA was elevated in POST (PRE: 10±6 vs. POST: 45±16 bursts/100 heartbeats, P<0.0001). Spontaneous sympathetic BRS was enhanced in POST (PRE: -2.0±1.2 vs. POST: -5.2±1.9 bursts/beat/mm Hg, P<0.0005). Sympathetic transduction to MAP was attenuated in POST (Time: P<0.001, Group: P<0.001, Interaction: P<0.01). These data suggest that sympathetic BRS may be enhanced in POST. Consistent with recent hypotheses, enhanced sensitivity of the arterial baroreflex's neural arc may signify a compensatory response to reduced efficiency of the peripheral arterial baroreflex arc (i.e., sympathetic transduction) to preserve BP buffering capacity.

Actigraphy-Based Sleep and Muscle Sympathetic Nerve Activity in Humans.

Short and insufficient sleep are prevalent and associated with cardiovascular disease, with the sympathetic nervous system as a suspected mediator. The purpose of the present study was to investigate the association between objective, actigraphy-based total sleep time (TST), sleep efficiency (SE) and cardiovascular and sympathetic regulation in healthy adults. We hypothesized that short TST and low SE would be associated with elevated resting blood pressure, heart rate (HR), and muscle sympathetic nerve activity (MSNA). Participants included 94 individuals (46 males, 48 females, age: 30±15 years, body mass index (BMI): 26±4 kg/m2). All participants underwent at least 7 days of at-home, wristwatch actigraphy monitoring (avg: 10 ± 3 days). Seated blood pressures were assessed using brachial blood pressure measurements, followed by a 10-minute supine autonomic testing session consisting of continuous HR (electrocardiogram), beat-by-beat blood pressure (finger plethysmograph), and MSNA (microneurography) monitoring. Partial correlations were used to determine the relationship between sleep and cardiovascular parameters while accounting for the influence of age, sex, and BMI. TST was not associated with MAP (R=-0.105, p=0.321), HR (R=0.093, p=0.383), or MSNA burst frequency (BF; R=-0.168, p=0.112) and incidence (BI; R=-0.162, p=0.124). Similarly, SE was not associated with MAP (R=-0.088, p=0.408), HR (R=-0.118, p=0.263), MSNA BF (R=0.038, p=0.723), or MSNA BI (R=0.079, p=0.459). In contrast to recent preliminary findings, our results do not support a significant association between actigraphy-based sleep duration or efficiency and measures of resting blood pressure, heart rate, and MSNA.

The Impact of Exercise Training on Muscle Sympathetic Nerve Activity: A Systematic Review and Meta-Analysis.

The purpose of this systematic review and meta-analysis was to examine the effects of exercise training on muscle sympathetic nerve activity (MSNA) in humans. Studies included exercise interventions (randomized controlled trials [RCTs], non-randomized controlled trials [non-RCTs] or pre-to-post intervention) that reported on adults (>18 years) where MSNA was directly assessed using microneurography, and relevant outcomes were assessed (MSNA [total activity, burst frequency, burst incidence, amplitude], heart rate, blood pressure [systolic blood pressure, diastolic blood pressure, or mean blood pressure], and aerobic capacity [maximal or peak oxygen consumption]). 40 intervention studies (n=1,253 individuals) were included. RCTs of exercise compared to no exercise illustrated that those randomized to the exercise intervention had a significant reduction in MSNA burst frequency and incidence compared to controls. This reduction in burst frequency was not different between individuals with cardiovascular disease compared to those without. However, the reduction in burst incidence was greater in those with cardiovascular disease (9 RCTs studies, n = 234, MD -21.08 bursts/100 hbs; 95% CI -16.51, -25.66; I2 = 63%) compared to those without (6 RCTs, n = 192, MD -10.92 bursts/100 hbs; 95% CI -4.12, -17.73; I2 = 76%). Meta-regression analyses demonstrated a dose-response relationship where individuals with higher burst frequency and incidence pre-intervention had a greater reduction in values post-intervention. These findings suggest that exercise training reduces muscle sympathetic nerve activity, which may be valuable for improving cardiovascular health.

Neural-Cardiovascular Responses to Orthostasis Following 8-Weeks of Home-Based Lower Leg Heating in Older Women with Hypertension

Background: Hypertension remains a significant health problem for older women (≥60 y). Though effective blood pressure (BP) interventions exist (e.g., exercise, medication), adherence to these options is low. Lower leg heat therapy represents a promising and easily implementable adjuvant treatment that may offer cardioprotective benefits. However, no studies have investigated lower leg heat therapy’s effects on BP and neural-cardiovascular function, let alone in older women with hypertension. Accordingly, we hypothesized that 8-weeks of home-based lower leg heat therapy in older women with hypertension would 1) reduce ambulatory BP and 2) reduce muscle sympathetic nerve activity (MSNA) while augmenting cardiac output and stroke volume during graded head-up tilt (HUT). Methods: Forty older women with hypertension (69 ± 5 y [mean±SD]) were randomized to either heat therapy (INT, 42°C; n = 20) or a thermoneutral control (CON, 35°C; n = 20). Each woman completed 8 wks of at-home sessions (~4/wk; 45 min/session) immersing their legs ~33 cm in a portable spa bath. 24-h ambulatory BP was measured pre- (PRE) and post-intervention (POST). A subset of women (n = 18 for each group) completed supine rest and 5 min of 30° and 60° HUT at each time point, whereby laboratory heart rate, systolic and diastolic BP, MSNA burst frequency and incidence (microneurography), cardiac output (acetylene rebreathing), and stroke volume (cardiac output/heart rate) were measured. Results: Between INT and CON, PRE ambulatory awake systolic BP (140 ± 7 vs. 142 ± 6 mmHg; P = 0.34) and diastolic BP (80 ± 6 vs. 79 ± 6 mmHg; P = 0.51) were not different, nor were PRE supine systolic BP, diastolic BP, or heart rate (all P &gt; 0.05). PRE supine resting MSNA burst frequency (36 ± 13 vs. 33 ± 16 bursts/min), MSNA burst incidence (54 ± 19 vs. 51 ± 22 bursts/100 heartbeats), cardiac output (4.9 ± 0.9 vs. 5.1 ± 1.0 L/min), and stroke volume (72 ± 15 vs. 76 ± 15 mL/beat) were not different between groups (all P &gt; 0.05). From PRE to POST neither ambulatory awake systolic nor diastolic BP differed between groups (all P &gt; 0.05). Despite this, POST laboratory systolic and diastolic BP were greater in INT (both P &lt; 0.05) but not in CON (both P &gt; 0.05) during HUT. POST laboratory heart rate was reduced in INT ( P = 0.025), and trended greater in CON ( P = 0.065) across HUT. Neither MSNA burst frequency nor burst incidence changed during HUT PRE to POST (all P &gt; 0.05). Despite no PRE to POST differences in cardiac output in either group (all P &gt; 0.05), INT had a greater overall POST stroke volume throughout HUT ( P = 0.011), while CON had a reduced stroke volume during 60° HUT ( P = 0.036). Conclusions: Contrary to our hypotheses, 8-weeks of home-based lower leg heat therapy did not improve ambulatory BP or HUT MSNA and cardiac output in older women with hypertension. However, women completing INT appeared to have a greater stroke volume and lower heart rate during HUT. Accordingly, these data suggest that 8-weeks of lower leg heat therapy in older women with hypertension may improve cardiac function during orthostasis without significant changes in sympathetic outflow or ambulatory BP. Supported by the National Institutes of Health (R01AG059314 and F32HL167556). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Spontaneous Sympathetic Baroreflex Sensitivity Is Impaired in Patients with Chronic Kidney Disease

Patients with chronic kidney disease (CKD) have chronic overactivation of the sympathetic nervous system that contributes to hypertension and increased cardiovascular risk. The sympathetic baroreflex is a major regulator of sympathetic activity in response to changes in blood pressure; however, limited information is available regarding sympathetic baroreflex control in non-dialysis patients with CKD. In the present study we tested the hypothesis that baroreflex control of muscle sympathetic nerve activity (MSNA) is attenuated in non-dialysis patients with CKD. In 17 sedentary patients with CKD stages III-IV (76% hypertensive and 29% with diabetes) [12 male/5 female, age: 57 ± 13 yr, 13 Black/4 White, systolic/diastolic BP: 122 ± 17/75 ± 7 mmHg, BMI: 31 ± 5 kg/m2, eGFR: 40 ± 14 mL/min/1.73m2] and 9 controls (CON) (89% hypertensive and 22% with diabetes) [7 male/2 female, age: 51 ± 13 yr, 8 Black/1 White, systolic/diastolic BP: 123 ± 6/79 ± 6 mmHg, BMI: 30 ± 6 kg/m2, eGFR: 95 ± 12 mL/min/1.73m2], resting beat-to-beat blood pressure (finger photoplethysmography), heart rate (electrocardiography) and muscle sympathetic nerve activity (MSNA, microneurography) were continuously recorded during 10 min of semi-recumbent rest. Weighted linear regression analysis between MSNA burst incidence and diastolic blood pressure was used to determine the spontaneous sympathetic baroreflex sensitivity (sBRS). Resting MSNA burst incidence was higher in patients with CKD [CKD: 70 ± 19 bursts (100 heart beats)−1. mmHg−1 versus CON: 47 ± 9 bursts (100 heart beats)−1. mmHg−1; p&lt;0.001], and a higher MSNA burst frequency was observed in CKD (CKD: 43 ± 11 bursts. min−1 versus CON: 32 ± 10 bursts. min−1; P=0.021], whereas resting mean arterial blood pressure (91 ± 9 mmHg versus 94 ± 5 mmHg; P=0.317) and heart rate were similar between groups. Patients with CKD had reduced sBRS compared to controls [CKD: -1.37 ± 0.59 bursts (100 heart beats)−1 mmHg−1 versus CON: -2.79 ± 1.33 bursts (100 heart beats)−1 mmHg−1; P=0.013]. The MSNA burst incidence (r = -0.63, p&lt;0.001) and the sBRS (r = -0.57, P=0.002) were significantly associated with the estimated glomerular filtration rate (eGFR). Overall, these preliminary findings suggest an attenuated sympathetic baroreflex sensitivity in patients with CKD compared with age and-comorbidities matched controls, with greater impairment in those with more severe kidney dysfunction. This work was supported by National Institutes of Health Grants R01HL135183 and R61AT010457 (J.P). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Young Trauma-Exposed Women with Low Sleep Effciency have Blunted Sympathetic Baroreflex Sensitivity and Higher Muscle Sympathetic Nerve Activity

Introduction: Poor sleep, a known risk factor for cardiovascular disease (CVD) and one of the American Heart Association’s essential 8th, is common after trauma-exposure. Although premenopausal women are thought to be protected from CVD, trauma exposure might increase their CVD risk. In a recent large epidemiological study examining sleep-related CVD comorbidities, the empirical cut off point for optimal sleep effciency (SE) was set at 83%, distinguishing between good and poor sleep effciency. Studies have suggested an overactive sympathetic nervous system and an impaired baroreflex sensitivity (BRS) as potential mechanisms of increased CVD risk. However, the impact of poor sleep effciency on muscle sympathetic nerve activity (MSNA) and BRS in young trauma-exposed women is unknown. We hypothesized that young trauma-exposed women with poor sleep effciency will present with impaired BRS and increased MSNA at rest. Methods: We collected data on 30 women (18 – 40 years) from diverse backgrounds who had been exposed to trauma. Sleep data was acquired via ActiWatch for 7 days and used to categorize our participants into two groups: good effciency (SE &gt; 83%, n=17) and poor effciency (SE &lt; 83%, n=13), with SE calculated as the percentage of time spent asleep while in bed. Additionally, we collected continuous noninvasive blood pressure (BP), heart rate (HR), and MSNA (burst frequency, incidence, and total activity) during 10 minutes of quiet rest. Sympathetic BRS was determined as the slope of the regression between individual sympathetic bursts and diastolic BP bins (3 mmHg), weighted against the number of cardiac cycles, utilizing an automated program (Ensemble, NZ). Results: There were no significant differences in trauma symptom severity, resting BP and HR between the two groups (p&gt;0.05 for all). However, resting sympathetic BRS was blunted in the poor SE (-0.10±0.88 bursts/100hb/mmHg) compared to the good SE (-1.44±1.58 bursts/100hb/mmHg, p=0.006) group, even after adjusting for age (p=0.009). Likewise, resting total MSNA was higher in the poor SE compared to the good SE after adjusting for age (p=0.028). MSNA burst frequency and burst incidence were comparable between the groups (p&gt;0.05). Conclusion: Our analyses revealed that poor sleep effciency is associated with decreased sympathetic baroreflex sensitivity and higher total muscle sympathetic activity at rest, regardless of age. Blunted sympathetic BRS may contribute to increased sympathetic activity in young women with poor sleep effciency. Future studies testing strategies to improve sleep effciency in this population could provide potential long-term cardiovascular benefits. UL1TR002494 and NIH K01HL161027 No disclosure. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Respiratory Modulation of Muscle Sympathetic Nerve Activity in Type 2 Diabetes Mellitus

Dysfunctional sympathetic neural regulation is present in patients with type 2 diabetes (T2D) with augmented muscle sympathetic nerve activity (MSNA) responses to handgrip exercise, cold pressor testing, and augmented sympathetic-blood pressure transduction identified. MSNA is modulated by respiration such that it is inhibited at higher lung volumes and increased at lower lung volumes. Herein we aimed to determine whether T2D affects the respiratory modulation of MSNA. Resting MSNA (microneurography) and respiration pattern (strain-gauge pneumobelt) were measured simultaneously in 20 patients with T2D (age 49.1±7.4 years, body mass index [BMI] 31.9±4.1 kg∙m−2, mean ± SD) and 13 age- and BMI-matched, healthy controls (46.3±9.4 years; 32.1±4.6 kg∙m−2). MSNA was stratified by the phase of respiration. Further comparisons were made between low lung volume (defined as 60-100% expiration + 0-60% inspiration) and high lung volume states (60-100% inspiration + 0-60% expiration). Resting MSNA burst frequency, burst incidence and total activity were similar between T2D and controls (p=0.953, p=0.624, and p=0.884, respectively). Both groups exhibited peak MSNA in late expiration to early inspiration, whilst inhibition of MSNA occurred during late inspiration to early expiration (respiratory phase p&lt;0.001 for burst frequency, incidence and total activity), though no group x respiratory phase interaction was observed (p&gt;0.05 for all MSNA measures). When MSNA responses were compared between lung volume states, percent reduction of MSNA burst incidence from low lung volume to high lung volume was less in T2D than controls (26.1±33.9 vs 50.1±25.6%, p=0.025). Furthermore, in T2D, there was a shift in the distribution of MSNA bursts with a greater proportion of bursts occurring at high lung volumes (i.e., burst count during high lung volume divided by total burst count) compared to controls (43.8±10.5 vs. 37.8±12.5% respectively, group x volume interaction p=0.04). Notably, the normal pattern of respiratory modulation of MSNA was absent in 5 T2D patients (non-modulators), whilst this did not occur in any control participants. Non-modulators had higher systolic blood pressure compared to modulators (138.7±16.6 vs. 123.2±10.6 mmHg respectively, p=0.024), with no differences in age, BMI, HbA1c, duration of T2D, or overall MSNA parameters (all p&lt;0.05). These results suggest that whilst respiratory modulation of MSNA occurs in T2D, its effect appears blunted compared to healthy controls. Notably, the usual pattern of respiratory-sympathetic coupling is absent in some T2D patients, which may be associated with higher resting systolic blood pressure. MP is supported by the Greenlane Research and Educational Fund (21/01/4153). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Interactions Between Reproductive Hormones and Neuro-Vascular Regulation During the Cold Pressor Test in Young Females

Recently, we reported that muscle sympathetic nerve activity (MSNA) is not predictive of vascular nor blood pressure outcomes during the cold pressor test (CPT) in young healthy females. Instead, we observed substantial variability in vascular responses to the CPT which ranged widely from decreases in blood flow and vascular conductance to increases in these same outcomes. Interindividual differences in circulating reproductive hormones may account for this female-specific variability in vascular responses to acute elevations in MSNA. Therefore, the purpose of this study was to test the hypothesis that reproductive hormones account for variability in MSNA, femoral blood flow (FBF), and femoral vascular conductance (FVC) during the CPT in females. We retrospectively assessed data from 9 young healthy females (age: 24±3 years) in the low hormone phase of their menstrual cycle (days 1-5). Intravenous blood samples were obtained and prospectively analyzed to assess concentrations of circulating reproductive hormones (radioimmunoassay). Integrated peroneal MSNA (microneurography; NeuroAmpEX, ADI) was quantified at rest and during a 3-minute hand CPT. Mean arterial pressure (MAP) was measured beat-by-beat (Finometer Midi, FMS) and duplex vascular ultrasound was used to measure FBF; FVC was quantified as FBF/MAP (mL/min/mmHg). All variables are expressed as the difference between the average CPT value and the average baseline value. CPT-induced changes in MSNA burst incidence (bursts/100hb) were not related to [17-beta-estradiol] (R2=0.05; P=0.60), [progesterone] (R2=0.11, P=0.47), or [free testosterone] (R2=0.01, P=0.81). Similarly, changes in FBF and FVC were not related to [17-beta-estradiol] (FBF: R2=0.04, P=0.67; FVC: R2=0.01, P=0.80) or [progesterone] (FBF: R2=0.04, P=0.67; FVC: R2=0.09, P=0.51). However, there was a negative correlation between [free testosterone] and the changes in both FBF (R2=0.69, P=0.02) and FVC (R2=0.66, P=0.03). In other words, females with higher free testosterone demonstrated larger decreases in FBF and FVC during the CPT relative to those with lower free testosterone concentrations. These data suggest that circulating free testosterone may act to increase the vasoconstrictive consequences of MSNA in females, and may account for the previously observed variability in vascular responses to MSNA during acute stress. This project was funded by: NSERC and FRQ-S. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Reduced resting beat-to-beat blood pressure variability in females with relapsing-remitting multiple sclerosis

BackgroundRelapsing-remitting multiple sclerosis (RRMS) is a demyelinating disease of the central nervous system and cardiovascular autonomic dysfunction has been well documented in this population. The sympathetic nervous system contributes to beat-to-beat blood pressure regulation primarily by baroreflex control of the peripheral vasculature which may be impaired in females with RRMS. Even at rest, attenuated sympathetic control of vasomotor tone may result in large and frequent blood pressure excursions (i.e., greater blood pressure variability). Therefore, the primary purpose of this investigation was to test the following hypotheses; (1) females with RRMS have augmented beat-to-beat blood pressure variability compared to healthy controls and (2) reduced sympathetic baroreflex sensitivity in females with RRMS is related to augmented blood pressure variability. MethodsElectrocardiogram and beat-to-beat blood pressure were continuously recorded during 8–10 min of supine rest in 26 females with clinically definite RRMS and 24 sex-, age- and BMI- matched healthy controls. Muscle sympathetic nerve activity (MSNA) was recorded in a subset of participants (MS, n = 15; CON, n = 14). Traditional statistical measurements of dispersions were used to index beat-to-beat blood pressure variability. Spontaneous sympathetic baroreflex sensitivity was quantified by sorting diastolic blood pressures into 3 mmHg bins and calculating MSNA burst incidence within each bin. Weighted linear regression was then used to account for the number of cardiac cycles in each bin and calculate slopes. Spontaneous cardiac baroreflex sensitivity was determined using the sequence method. ResultsGroups had similar resting mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), MSNA burst frequency and MSNA burst incidence (All P > 0.05). The standard deviation and interquartile range of MAP, SBP and DBP were less in females with RRMS compared to healthy controls (All P < 0.05). There were no between groups differences in sympathetic baroreflex sensitivity or cardiac baroreflex sensitivity (Both P > 0.05) and baroreflex sensitivity measures were not related to any indices of blood pressure variability (Both P > 0.05). ConclusionThese data suggest that females with RRMS have reduced beat-to-beat blood pressure variability. However, this does not appear to be related to changes in sympathetic or cardiac baroreflex sensitivity.

The effect of hypoxemia on muscle sympathetic nerve activity and cardiovascular function: a systematic review and meta-analysis.

We conducted a systematic review and meta-analysis to determine the effect of acute poikilocapnic, high-altitude, and acute isocapnia hypoxemia on muscle sympathetic nerve activity (MSNA) and cardiovascular function. A comprehensive search across electronic databases was performed until June 2021. All observational designs were included: population (healthy individuals); exposures (MSNA during hypoxemia); comparators (hypoxemia severity and duration); outcomes (MSNA; heart rate, HR; and mean arterial pressure, MAP). Sixty-one studies were included in the meta-analysis. MSNA burst frequency increased by a greater extent during high-altitude hypoxemia [P < 0.001; mean difference (MD), +22.5 bursts/min; confidence interval (CI) = -19.20 to 25.84] compared with acute poikilocapnic hypoxemia (P < 0.001; MD, +5.63 bursts/min; CI = -4.09 to 7.17) and isocapnic hypoxemia (P < 0.001; MD, +4.72 bursts/min; CI = -3.37 to 6.07). MSNA burst amplitude was only elevated during acute isocapnic hypoxemia (P = 0.03; standard MD, +0.46 au; CI = -0.03 to 0.90), and MSNA burst incidence was only elevated during high-altitude hypoxemia [P < 0.001; MD, 33.05 bursts/100 heartbeats; CI = -28.59 to 37.51]. Meta-regression analysis indicated a strong relationship between MSNA burst frequency and hypoxemia severity for acute isocapnic studies (P < 0.001) but not acute poikilocapnia (P = 0.098). HR increased by the same extent across each type of hypoxemia [P < 0.001; MD +13.81 heartbeats/min; 95% CI = 12.59-15.03]. MAP increased during high-altitude hypoxemia (P < 0.001; MD, +5.06 mmHg; CI = 3.14-6.99), and acute isocapnic hypoxemia (P < 0.001; MD, +1.91 mmHg; CI = 0.84-2.97), but not during acute poikilocapnic hypoxemia (P = 0.95). Both hypoxemia type and severity influenced sympathetic nerve and cardiovascular function. These data are important for the better understanding of healthy human adaptation to hypoxemia.

Age- and sex-related differences in sympathetic vascular transduction and neurohemodynamic balance in humans.

Bursts of muscle sympathetic nerve activity (MSNA) and the ensuing vasoconstriction are pivotal determinants of beat-by-beat blood pressure regulation. Although age and sex impact blood pressure regulation, how these factors affect the central and peripheral arcs of the baroreflex remains unclear. In 27 young [25 (SD 3) yr] males (YM; n = 14) and females (YF; n = 13) and 23 older [71 (SD 5) yr] males (OM; n = 11) and females (OF; n = 12), femoral artery blood flow, blood pressure, and MSNA were recorded for 10 min of supine rest. Sympathetic baroreflex sensitivity (i.e., central arc) was quantified as the relationship between diastolic blood pressure and MSNA burst incidence. Signal averaging was used to determine sympathetic vascular transduction into leg vascular conductance (LVC) for 12 cardiac cycles following MSNA bursts (i.e., peripheral arc). Older adults demonstrated attenuated sympathetic transduction into LVC (both P < 0.001) following MSNA bursts, and smaller increases in sympathetic transduction as a function of MSNA burst size and firing pattern compared with young adults (range, P = 0.004-0.032). YM (r2 = 0.36; P = 0.032) and OM (r2 = 0.51; P = 0.014) exhibited an inverse relationship between the central and peripheral arcs of the baroreflex, whereas females did not (YF, r2 = 0.03, P = 0.621; OF, r2 = 0.06, P = 0.445). MSNA burst incidence was inversely related to sympathetic transduction in YM and OF (range, P = 0.03-0.046) but not in YF or OM (range, P = 0.360-0.603). These data indicate that age is associated with attenuated sympathetic vascular transduction, whereas age- and sex-specific changes are present in the relationship between the central and peripheral arcs of the baroreflex regulation of blood pressure.NEW & NOTEWORTHY Sympathetic vascular transduction is attenuated in older compared with young adults, regardless of biological sex. Males, but not females (regardless of age), demonstrate an inverse relationship between central (sympathetic baroreflex sensitivity) and peripheral (sympathetic vascular transduction) components of the baroreflex arc. Young males and older females exhibit an inverse relationship between resting sympathetic outflow and sympathetic vascular transduction. Our results indicate that age and sex exert independent and interactive effects on sympathetic vascular transduction and sympathetic neurohemodynamic balance in humans.

The interactive effects of age and sex on the neuro-cardiovascular responses during fatiguing rhythmic handgrip exercise.

The impact of age on exercise pressor responses is equivocal, likely because of sex-specific neuro-cardiovascular changes with age. However, assessments of the interactive effects of age and sex on muscle sympathetic nerve activity (MSNA) responses to exercise are lacking. We tested the hypothesis that older females would exhibit exaggerated increases in blood pressure (BP) and MSNA discharge patterns during handgrip exercise compared with similarly aged males and young adults. Twenty-five young (25 (2) years; mean (SD)) males (YM; n=12) and females (YF; n=13) and 23 older (71 (5) years) males (OM; n=11) and females (OF; n=12) underwent assessments of BP, total peripheral resistance (TPR; Modelflow) and MSNA action potential (AP) discharge patterns (microneurography) during incremental rhythmic handgrip exercise and post-exercise circulatory occlusion (PECO). OM demonstrated larger ∆BP and ∆TPR from baseline than YM (both P < 0.001) despite smaller increases in ∆APs/burst (OM: 0.4 (3) vs. YM: 5 (3) spikes/burst, P < 0.001) and ∆AP clusters/burst (OM: 0.1 (1) vs. YM: 1.8 (1) clusters/burst, P < 0.001) during exercise. Testosterone was lower in OM than YM (P < 0.001) and was inversely related to ∆BP but positively related to ∆AP clusters/burst in males (both P=0.03). Conversely, YF and OF demonstrated similar ∆BP and ∆AP discharge during exercise (range: P=0.75-0.96). Age and sex did not impact haemodynamics or AP discharge during PECO (range: P=0.08-0.94). Altogether, age-related changes in neuro-cardiovascular reactivity exist in males but not females during fatiguing exercise and seem to be related to testosterone. This sex-specific impact of age underscores the importance of considering biological sex when assessing age-related changes in neuro-cardiovascular control during exercise. KEY POINTS: Older males have the largest increase in blood pressure despite having the smallest increases in sympathetic vasomotor outflow during rhythmic handgrip exercise. Young males demonstrate greater increases in sympathetic action potential (AP) discharge compared with young females during rhythmic handgrip exercise. Older adults (regardless of sex) demonstrate smaller increases in muscle sympathetic nerve activity (MSNA) burst amplitude and total AP clusters compared with young adults during exercise, as well as smaller increases in integrated MSNA burst frequency, incidence and total MSNA activity during post-exercise circulatory occlusion (i.e. independent effect of age). Males, but not females (regardless of age), reflexively modify AP conduction velocity during exercise. Our results indicate that age and sex independently and interactively impact the neural and cardiovascular homeostatic adjustments to fatiguing small muscle mass exercise.

Decentering and baroreflex sensitivity in adults with elevated blood pressure

Previous studies have linked the ability to decenter, a non-judgmental view of emotions, with lower arterial stiffness and better nocturnal blood pressure dipping in adults. It is unknown however if autonomic regulation of blood pressure is linked to decentering. Therefore, the purpose of this study was to determine if decentering ability is related to cardiovagal or sympathetic baroreflex sensitivity. Thirty-three adults (age 25±6 years; BMI 25±3 kg/m2) with resting blood pressure ≥120/80 mmHg volunteered for this study. All participants had a BMI &lt;30 kg/m2, and had no history of smoking, diabetes, or prescriptions for blood pressure or cardiac function. Participants completed an 11-item experiences questionnaire to evaluate decentering, and then were equipped for a supine autonomic evaluation. The autonomic evaluation included continuous recording of heart rate via 3-lead ECG, muscle sympathetic nerve activity (MSNA) via microneurography, and beat-to-beat blood pressure via finger photoplethysmography. Cardiovagal baroreflex sensitivity (n=33) included estimation of vagal activation by evaluating up-up relationships between systolic arterial pressure (SAP) and R-R intervals of the ECG. Vagal withdrawal was also estimated via the down-down relationships between SAP and R-R intervals. Spontaneous sympathetic baroreflex sensitivity (n=26) was evaluated by evaluating the relationship between changes in diastolic arterial pressure (DAP) in 3 mmHg bins vs. changes in MSNA burst incidence (i.e., bursts / 100 heart beats). Results from 2-tailed Pearson correlation analyses revealed that there was not a relationship between decentering and vagal activation (r=-0.07; p=0.71) or between decentering and vagal withdrawal (r=-0.28; p=0.12). Likewise, there was no relationship between decentering and sympathetic baroreflex sensitivity (r=0.10; p=0.64). Our findings suggest that there is not a clear link between decentering and autonomic regulation of blood pressure as estimated through both cardiovagal and baroreflex sensitivity. NIH (1R15HL140596-01); Nils K. Nelson Endowment Fund This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Sex-specific impact of aging on muscle sympathetic neural discharge patterns during incremental rhythmic handgrip exercise

Sex-disparities exist in the risk of developing hypertension throughout the lifespan, with a greater prevalence of hypertension amongst postmenopausal females compared to similarly aged males. Though the underlying mechanisms are multifactorial, exaggerated sympathetic neuro-cardiovascular reactivity may be an important contributor. Indeed, postmenopausal females exhibit exaggerated exercise pressor responses compared to young adults, and older males. However, the interactive effects of age and sex on muscle sympathetic nerve activity (MSNA) and action potential (AP) coding patterns during exercise remains unclear. We hypothesized that older females would exhibit the greatest increase in MSNA and AP recruitment during exercise and post-exercise circulatory occlusion (PECO) relative to young males and females, as well as older males. MSNA and AP discharge patterns (microneurography and continuous wavelet transform) were assessed in 12 young males (YM (mean±SD); 26±4, years), 11 young females (YF; 25±4 years), 11 older males (OM; 71±11 years), and 12 older females (OF; 71±4 years) during incremental rhythmic handgrip exercise to fatigue followed by 2 minutes of PECO. At peak exercise, OM demonstrated a smaller change from baseline (Δ) in MSNA burst incidence (BI) compared to all other groups (YM: Δ8±9, YF: Δ9±8, OM: Δ-6±8, OF: Δ6±7 bursts/100heartbeats; all ANOVA post-hoc P&lt;0.05), whereas ΔMSNA burst frequency (BF), Δburst amplitude (BA), and Δtotal activity were not different between groups (all P&gt;0.05). Conversely, YM demonstrated greater ΔAPs/burst (YM: Δ5±3, OM: Δ0.4±3, OF: Δ2±2 APs/burst; post-hoc P&lt;0.05) and ΔAP clusters/burst (YM: Δ2±1, OM: Δ0.1±1, OF: Δ0.7±0.7 Clusters/burst; post-hoc P&lt;0.05) compared to OM and OF, but not compared to YF (Δ2±3 APs/burst and Δ0.9±0.8 clusters/burst; both P≥0.07). However, no group differences were observed in the recruitment of larger axons (YM: Δ6±2, YF: Δ4±2, OM: Δ2±5, OF: Δ4±3 clusters; P=0.33). Contrary to exercise, group-by-time interactions existed during PECO for ΔMSNA BF ( P&lt;0.01), ΔBI ( P&lt;0.01), and Δtotal activity ( P&lt;0.01) where greater increases occurred during the first minute of PECO in young compared to older adults (all post-hoc P&lt;0.05), whereas in the final minute of PECO, MSNA ΔBF and ΔBI were only greater in YM compared to OM and OF (all P&lt;0.05), and total activity was greater in YM and YF compared to OF only (all P&lt;0.05). No group-by-time interactions were observed for ΔMSNA BA ( P=0.37), ΔAPs/burst ( P=0.94), ΔAP clusters/burst ( P=0.95) or Δtotal AP clusters ( P=0.41) during PECO. Altogether, MSNA and AP reactivity during exercise was not exaggerated in OF, but age-related reductions in AP recruitment were observed in males. During PECO, MSNA responses were lower in older relative to young adults but, AP recruitment was unaltered by age. Thus, exaggerated MSNA or AP reactivity may not explain the greater prevalence of hypertension in OF. Supported by the Natural Sciences and Engineering Council of Canada, and IEEM Indirect Funds. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Trait anxiety is associated with blood pressure and muscle sympathetic nerve activity

Heightened anxiety is associated with an increased risk for cardiovascular diseases such as coronary heart disease and hypertension. While hyperactivity of the sympathetic nervous system has been suggested to mediate this relationship, direct measures of muscle sympathetic nerve activity (MSNA) in people with elevated anxiety have indicated little, if any, alterations in baseline sympathetic function. However, studies examining anxiety and MSNA have been limited by small sample sizes and lack of detail on anxiety severity, limiting the ability to investigate subtle interactions. The present study assessed associations between trait anxiety, mean arterial pressure (MAP), and MSNA using a large, representative sample of healthy young men and women, with an exploratory assessment of sex-specific interactions. We hypothesized that heightened trait anxiety would be associated with elevated resting MAP and MSNA. Trait anxiety was assessed using the Spielberger Trait Anxiety Inventory (STAI) in 97 healthy adults (52 male, 45 female; 25±1 years; 26±1 kg/m 2 ). In each participant, the average of three seated brachial blood pressures was recorded and used in subsequent analysis. All participants underwent an autonomic function test that simultaneously assessed heart rate (HR), beat-to-beat blood pressure, MSNA burst frequency (BF) and incidence (BI) during 5-10 minutes of supine rest. MSNA recordings were captured in 91 participants. Multiple regression was used to test the relationship between STAI, MAP, MSNA, and HR while accounting for age and sex. Sex-specific interactions were explored with correlations controlling for age. The regression model significantly predicted MAP (R 2 =.196, P&lt;0.001), BF (R 2 =.136, P=0.005), and BI (R 2 =.150, P=0.003), but not HR (R 2 =.055, P=0.155). STAI scores were independently associated with MAP (β=.207, P=0.029), BF (β=.245, P=0.016), and BI (β=.224, P=0.027). In males, STAI was correlated with MAP (R=.277, P=0.049), BF (R=.363, P=0.009), and BI (R=.346, P=0.013), but not HR (R=.140, P=0.326). In contrast, STAI was not associated with MAP (R=.174, P=0.260), BF (R=.094, P=0.574), BI (R=.069, P=0.681), or HR (R=.226, P=0.141) in females. In a large sample of healthy adults, our results highlight the relationship between the severity of trait anxiety, resting blood pressure, and sympathetic outflow, with a more pronounced relationship in males. Support: NIH (AA-024892, 1R15HL140596-01, AG064038-01A1, U54GM115371; P20GM103474, 2TL1 TR002318). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Sex differences in autonomic and cardiovascular responses during lower-body negative pressure

Female adults have a lower tolerance to central hypovolemia, simulated by tilt testing and lower body negative pressure (LBNP; PMID: 26109186). However, the mechanisms responsible for this observation remain unknown. Previous studies investigated sex differences at baseline and presyncope, but the intermediate responses are not fully understood, particularly when expressed as a percentage of tolerance. Therefore, the purpose of this study was to compare autonomic and cardiovascular responses to a simulated hemorrhage between female and male adults at the same relative percentage of their tolerance. We tested the hypothesis that females would have lower blood pressure (BP) and muscle sympathetic nerve activity (MSNA) at the same relative percentage of their tolerance. Eight female (28±8 years old, 171±8 cm, 77±6 kg, BMI: 27±3 kg/m 2 ) and eight male (age: 32±7 years old, height: 178±9 cm, mass: 86±10 kg, BMI: 27±2 kg/m 2 ) adults completed a progressive LBNP protocol that started at -40 mmHg and was further reduced by 10 mmHg every 3 minutes until the participant reached pre-syncope. Presyncope was based on the following criteria: continued reports by the subject of feeling faint and/or nauseous; a rapid decline in blood pressure resulting in systolic blood pressure &lt; 80 mmHg; and/or a relative bradycardia accompanied by narrowing of pulse pressure. LBNP tolerance was quantified as a cumulative stress index (CSI) (mmHg·min) and was compared between sexes using an unpaired t-test. MSNA (microneurography - radial nerve), beat-to-beat blood pressure (BP; Finometer), and heart rate (HR) were obtained at baseline, at 33% and 66% of maximum CSI (60-second averages for both), and the last 30 seconds before 100% CSI (i.e., presyncope). Data were statistically analyzed between the sexes using mixed effects analysis and are presented as mean ± SD. Consistent with prior findings, tolerance to LBNP was lower in females (female: 607±369 vs. male: 960±339 mmHg·min, p = 0.067). There were no differences in systolic, mean, or diastolic BP or HR between the sexes (e.g., main effect of sex, p &gt; 0.199 for all indices) throughout the protocol. MSNA burst frequency (bursts/min) (baseline: 18±8 vs. 25±11; 33% CSI: 30±13 vs. 50±5; 66% CSI: 38±11 vs. 56±4; 100% CSI: 28±10 vs. 40±12; sex: p = 0.004, stage: p &lt; 0.0001, interaction: p = 0.704) and burst incidence (bursts/100 cardiac cycles) (baseline: 29±9 vs. 41±20; 33% CSI: 38±21 vs. 58±10; 66% CSI: 35±18 vs. 52±10; 100% CSI: 32±18 vs. 37±12; sex: p = 0.047, stage: p = 0.022, interaction: p = 0.952) were lower in females than males throughout the protocol, respectively. However, there was no interaction between sexes and relative LBNP stages for MSNA burst frequency or burst incidence. These findings suggest a lack of sex differences in the magnitude of the increase of MSNA throughout LBNP and that lower basal sympathetic activity may be related to reduced tolerance to central hypovolemia. Department of Defense - US Army W81XWH1820012 (CGC) This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Effects of chlorthalidone treatment on neural-cardiovascular responses to orthostasis in older women with hypertension

Background: Hypertension remains a significant public health issue for older women (&gt;60 y) in the United States. Diuretics are an important first-line treatment for blood pressure (BP) management. Our group and others have demonstrated that certain diuretics (e.g., chlorthalidone [CTD], hydrochlorothiazide) can increase muscle sympathetic nerve activity (MSNA) and decrease cardiac output (Qc) at rest and during orthostasis. One possible mechanism may be baroreflex-mediated sympathoexcitation due to reduced BP, which may be amplified during orthostasis. Whether this observation holds against untreated, yet BP-matched, hypertension remains unknown. Therefore, we hypothesized that women with hypertension taking CTD would have augmented MSNA and blunted Qc at rest and during graded head-up tilt (HUT) compared to women with untreated hypertension (CON). Methods: Sixteen (8 CTD, 8 CON; 68±4 vs. 70±4 y [mean±SD]) older women with hypertension were studied. All women completed a 24 h ambulatory BP after anti-hypertensive washout alone (CON) or washout followed by 2 wks of CTD treatment (CTD). Systolic and diastolic BP (SBP and DBP), heart rate (HR), MSNA (microneurography), Qc (acetylene rebreathing), and systemic vascular resistance (SVR; mean arterial BP·Qc -1 ·80) were measured during supine baseline and 5 min each of 30° and 60° HUT. Results: Awake SBP (142±7 vs. 140±2 mmHg; P=0.408) and DBP (82±6 vs. 81±5 mmHg; P=0.866) were not different between CTD and CON, nor were resting cuff SBP, cuff DBP, and HR (all P&gt;0.05). No differences were noted between CTD and CON for resting MSNA burst frequency (32±11 vs. 24±12 bursts·min -1 ; P=0.160) or incidence (49±17 vs. 38±17 bursts·100 heartbeats -1 ; P=0.197). Further, there were no differences between CTD and CON for Qc (4.8±0.9 vs. 5.1±0.9 L·min -1 ; P=0.529) or SVR (1649±361 vs. 1562±336 dyne·s·cm -5 ; P=0.637). While DBP and HR increased across HUT (both P&lt;0.05), there were no group differences for ΔSBP, ΔDBP, or ΔHR (all P&gt;0.05). While ΔMSNA burst frequency/incidence and ΔSVR were not different between groups during HUT (all P&gt;0.05), there was a trend for ΔQc to be lower in the CTD group ( P=0.067). Conclusions: Contrary to our hypothesis, MSNA appeared to not be augmented in CTD at rest or during graded HUT relative to CON. Additionally, though resting Qc was not reduced, there was a trend towards a lower Qc during tilt in the CTD group. Accordingly, these preliminary data suggest that CTD may not elicit sympathetic hyperactivity relative to untreated, BP-matched hypertension, but may still attenuate Qc during orthostasis in older women with hypertension. Supported by the National Institutes of Health (R01AG059314) This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Greater resting muscle sympathetic nerve activity reduces cold pressor autonomic reactivity in older women, but not older men.

Previous work demonstrates augmented muscle sympathetic nerve activity (MSNA) responses to the cold pressor test (CPT) in older women. Given its interindividual variability, however, the influence of baseline MSNA on CPT reactivity in older adults remains unknown. Sixty volunteers (60-83y; 30 women) completed testing where MSNA (microneurography), blood pressure (BP), and heart rate (HR) were recorded during baseline and a 2-min CPT (~4°C). Participant data were terciled by baseline MSNA (n=10/group); comparisons were made between the high baseline men (HM) and women (HW), and low baseline men (LM) and women (LW). By design, HM and HW, vs. LM and LW, had greater baseline MSNA burst frequency (37±5 and 38±3 vs. 9±4 and 15±5 bursts/min) and burst incidence (59±14 and 60±8 vs. 16±10 and 23±7 bursts/100hbs; both P<0.001). However, baseline BP and HR were not different between the groups (all P>0.05). During the CPT, there were no differences in the increase in BP and HR (all P>0.05). Conversely, ΔMSNA burst frequency was lower in HW vs. LW (8±9 vs. 22±12 bursts/min; P=0.012) yet was similar in HM vs. LM (17±12 vs. 19±10 bursts/min, P=0.994). Further, ΔMSNA burst incidence was lower in HW vs. LW (9±13 vs. 28±16 bursts/100hbs; P=0.020), with no differences between HM vs. LM (21±17 vs. 31±17 bursts/100hbs; P=0.455). Our findings suggest that heightened baseline activity in older women attenuates the typical CPT-mediated increase in MSNA without changing cardiovascular reactivity. While the underlying mechanisms remain unknown, altered sympathetic recruitment or neurovascular transduction may contribute to these disparate responses.

Blood pressure and muscle sympathetic nerve activity are associated with trait anxiety in humans.

Chronic anxiety is prevalent and associated with an increased risk of cardiovascular disease. Prior studies that have reported a relationship between muscle sympathetic nerve activity (MSNA) and anxiety have focused on participants with anxiety disorders and/or metabolic syndrome. The present study leverages a large cohort of healthy adults devoid of cardiometabolic disorders to examine the hypothesis that trait anxiety severity is positively associated with resting MSNA and blood pressure. Resting blood pressure (BP) (sphygmomanometer and finger plethysmography), MSNA (microneurography), and heart rate (HR; electrocardiogram) were collected in 88 healthy participants (52 males, 36 females, 25 ± 1 yr, 25 ± 1 kg/m2). Multiple linear regression was performed to assess the independent relationship between trait anxiety, MSNA, resting BP, and HR while controlling for age and sex. Trait anxiety was significantly correlated with systolic arterial pressure (SAP; r = 0.251, P = 0.018), diastolic arterial pressure (DAP; r = 0.291, P = 0.006), mean arterial pressure (MAP; r = 0.328, P = 0.002), MSNA burst frequency (BF; r = 0.237, P = 0.026), and MSNA burst incidence (BI; r = 0.225, P = 0.035). When controlling for the effects of age and sex, trait anxiety was independently associated with SAP (β = 0.206, P = 0.028), DAP (β = 0.317, P = 0.002), MAP (β = 0.325, P = 0.001), MSNA BF (β = 0.227, P = 0.030), and MSNA BI (β = 0.214, P = 0.038). Trait anxiety is associated with increased blood pressure and MSNA, demonstrating an important relationship between anxiety and autonomic blood pressure regulation.NEW & NOTEWORTHY Anxiety is associated with development of cardiovascular disease. Although the sympathetic nervous system is a likely mediator of this relationship, populations with chronic anxiety have shown little, if any, alteration in resting levels of directly recorded muscle sympathetic nerve activity (MSNA). The present study is the first to reveal an independent relationship between trait anxiety, resting blood pressure, and MSNA in a large cohort of healthy males and females devoid of cardiometabolic comorbidities.

Upper and lower limb muscle sympathetic responses to contralateral exercise in healthy humans: A pilot study.

Muscle sympathetic nerve activity (MSNA) is similar between limbs at rest, although a subset of MSNA bursts do demonstrate limb-specific discharge. Whether limb differences in MSNA synchronicity are present during exercise remains controversial. We concurrently measured MSNA from the radial and fibular nerves at rest and during rhythmic handgrip (RHG), static handgrip (SHG), and post-exercise circulatory occlusion (PECO). MSNA burst frequency and incidence were similar between nerve sites during all conditions. Synchronous bursts resulted in larger increases in sympathetic-blood pressure transduction compared to isolated bursts (∆+3.6±2.1 vs. +2.3±2.4mmHg, P=0.01). The proportion of bursts firing synchronously between nerves at rest was slightly increased during RHG ([rest vs. exercise; mean±SD] 45.3±7.1 vs. 61.6±7.2%) and similar during SHG (56.2±7.2 vs. 54±10.6%). In contrast, burst firing synchronicity increased during PECO (83.8±12.4%) alongside larger burst amplitudes. Inter-limb differences in resting MSNA are preserved during handgrip exercise, whereas isolated metaboreflex activation results in greater burst synchronization between limbs.